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Biomedical subjects

D W Swanson

Publications and source records attributed to D W Swanson.

At least 19 recordsLinked to original sources
PubMed1995

Timing of completed suicides among residents of Olmsted County, Minnesota, 1951-1985.

Previous studies of suicide timing may have been biased by incomplete ascertainment of suicides and by delays between the suicidal act and subsequent death. Those potential biases were assessed and minimized in this population-based study by using the unique resources of the Rochester Epidemiology Project in Olmsted County, Minnesota. Using these more accurate data, we confirmed previous reports of no excess suicides on birthdays (+/- 3 days), or during 3 United States national holidays. While most prior reports found excess post-holiday suicides and suicide peaks on Mondays, those findings were not observed in Olmsted County. Because 93% of deaths occurred on the date of the suicidal act, using date of death instead of the actual date of suicide is sufficient for most research purposes.

Adult↗
PubMed1990

Suicide in Olmsted County, Minnesota, 1951 through 1985.

During the 35-year period 1951 through 1985, 274 completed suicides occurred among residents of Olmsted County, Minnesota. The overall age- and sex-adjusted incidence was 12.5 per 100,000 person-years (95% confidence interval, 11.0 to 14.0), similar to the national averages, and rates were comparable for urban and rural portions of the county. Men outnumbered women 3.6 to 1, and the sex ratio of age-adjusted incidence rates was 4.5:1. The incidence rates increased after middle age for men but not for women. The most common suicide methods were gunshot wounds for men and poisoning for women. Two-thirds of the suicides occurred at home and were usually discovered by family members or friends. Almost half of all suicide victims were unmarried. This figure seems high, as does the greater proportion of unemployed persons than employed persons among those who committed suicide, but denominator data are unavailable.

Adolescent↗
PubMed1986

Paranoid disorder: the Soviet viewpoint.

The Russian-language psychiatric literature on the paranoid disorders was reviewed for a recent 10-year period. The authors were from a variety of facilities and geographic locations. Bibliography references were primarily European, although 41% of the articles included references to American publications. The paranoid patient population was similar to that in the United States. There was extensive longitudinal study of the disorders; epidemiologic investigations, diagnostic classification, pharmacotherapy, treatment outcome, and etiologic theories allowed comparison with these issues in the United States.

Adult↗
PubMed1984

Normal serum thyroxine values in patients with acute psychiatric illness.

The medical records of 278 consecutive patients with acute psychiatric illness admitted to a closed psychiatric unit after admission from the emergency room were reviewed. Serum thyroxine levels had been determined within 72 hours of admission in 106 patients (38 percent); in 74 of these patients (70 percent), the determination had been made within 24 hours. Ten patients (9 percent) were hypothyroxinemic, but further thyroid testing revealed that they were functionally euthyroid. Only one patient had hyperthyroxinemia, which was considered secondary to her postpartum state. The prevalence of hypothyroxinemia in the population studied is consistent with that in previous reports. However, the striking absence of hyperthyroxinemia in these patients is contrary to findings in several recent reports. Further prospective studies should clarify this issue.

Adolescent↗
PubMed1984

Chronic pain as a third pathologic emotion.

Chronic pain is often difficult to explain on the basis of objective findings. Various theoretical models are available. The hypothesis advanced here is that chronic nonprogressive pain is primarily a neuropsychologic event and that it is in the same category as the emotions of anxiety and depression, with each emotional state having neurochemical correlates now achieving some definition. General systems theory and analogy are used to compare acute and chronic pain with the phenomena of fear and anxiety and also with grief and depression.

Anxiety↗
PubMed1983

Are patients with chronic pain depressed?

Of 100 consecutive patients treated in a program for management of chronic pain, 25 were definitely depressed, 39 were probably depressed, and 36 were not depressed. Comparisons between the definitely depressed and nondepressed groups showed them to have strikingly similar characteristics as well as treatment outcome. Nearly 90% of the definitely depressed patients showed resolution of their depression without use of antidepressant medication.

Adult↗
PubMed1981

Problems with the use of oxycodone compound in patients with chronic pain.

In a pain management program (200 patients), a group of daily users of oxycodone compound (29 patients) and a subgroup who were taking a "high dose" of oxycodone compound (13 patients) were compared with a group of 171 non-users of oxycodone compound. A significantly lower treatment success rate was observed in the users (P = 0.04) and high-dose users (P = 0.03). A similar trend was seen in preliminary data available in a larger sample (514 patients). Continued study of these findings is necessary. Meanwhile, in patients with chronic pain, there should be cautious use of this compound.

Aspirin↗
PubMed1981

Chronic pain patients and spouses: marital and sexual adjustment.

Fifty married patients who were referred to a pain-management program and their spouses were interviewed independently concerning marital-sexual adjustment. The effect of pain on frequency and quality of sexual activity, and the effect of sexual activity on pain, showed a consistent trend toward deterioration in sexual activity after the onset of pain complaints in both patient and spouse groups. Ratings of overall sexual adjustments and adjustment in marriage were essentially the same for both groups before the onset of pain; but after pain onset a significantly large number of spouses rated their marriage below average, whereas most patients rated it average or above average. For the pain patient and his or her spouse, it seems very important that open and candid communication exist about the constant problem of adjusting to chronic pain, and the spouse should participate in the treatment program.

Adaptation, Psychological↗
PubMed1980

Patients complaining of extreme pain.

Some patients chronic pain say that their pain is both constant and extreme. A graphic rating scale was used to identify 35 patients in a pain management program who complained of extreme pain. They were compared with 31 subjects who rated their pain as low. The patients with extreme pain were older, were more often female, had a longer history of pain, were disabled longer, had had more surgical procedures and hospitalizations, were more dependent on drugs, had higher ratings of bodily and facial pain behavior, and responded less well to treatment than the patients in the low-pain group. A rating of extreme pain remained a rather fixed presentation. It did not correlate with orthopedic or neurologic diagnoses. Possible explanations of the complaint are discussed, and illustrative case material is presented.

Adult↗
PubMed1979

Results of behavior modification in the treatment of chronic pain.

Two hundred patients with chronic pain were treated in an in-patient program in which behavior modification was the major therapeutic modality. The patients were characterized by having had pain of many years' duration, multiple operations, treatment failures, prolonged disability, compensation factors, and dependency on medication. At hospital dismissal, 59% of the patients had achieved moderate improvement or better. At a 3-mo follow-up, 40% of the admitted patients (75% of those successfully treated) were still doing well, and after 1 yr, 25% of those originally admitted continued to do well (65% of those successfully treated).

Adult↗
PubMed1979

Drug abuse and dependency in patients with chronic pain.

Of 144 patients with chronic pain of nonmalignant cause, 35 (24%) were drug-dependent, 59 (41%) drug abusers, and 50 (35%) nonabusers. Codeine and oxycodone (Percodan) were most frequently abused. In regard to characteristics tested, differences between the groups were not great; but there was a significant difference in outcome between nonabuse and dependent groups. Early detection and treatment of drug abuse should minimize some of the difficulties involved in management of treatment-resistive patients with chronic pain.

Age Factors↗
PubMed1977

Tardive dyskinesia: relationship with a primary affective disorder.

We reviewed all Mayo Clinic case histories in which a diagnosis of tardive dyskinesia or dyskinesia might have been recorded during the years 1965 through 1973 and interviewed 18 consecutive patients in the Department of Psychiatry and Psychology. Among the histories and patients, we found a high incidence of primary affective disorders. Four of the five men had a history of chronic alcohol abuse and symptoms of depression. We recommend that people who have primary affective disorders and chronic alcohol abuse with depression should be given antipsychotic medication, stimulants, or diazepam only after extremely careful consideration.

Adult↗
PubMed1977

Psychiatric consultation in the chronic pain patient.

A process and technique for psychiatric evaluation of chronic pain patients are discussed. It is the task of a psychiatrist to rule in or rule out a psychiatric component rather than to assume the existence of "psychogenic" pain when there is a negative medical and surgical examination. Accurate communications about any psychiatric components to the referring physician, without premature judgment on "cause" of pain, lead to themost accurate decisions about future treatment.

Chronic Disease↗